Geriatric hip fractures Flashcards
1
Q
Risk factors for hip fractures in the elderly
A
- Osteoporosis
- falls
2
Q
Explain osteoporosis as a risk factor for hip fractures
A
- Age/race
- body frame
- family hixtory
- medications
- reduced GI absorption of Ca
- decreased bone mineral density causes it to fracture more easily
3
Q
Explain falls as a risk factor for hip fractures
A
- muscle strength loss
- slowed reflex reaction time
- vision problems
- medication/metabolism
- *sometimes elderly patients need their med dosage readjusted
4
Q
Hip fracture classifications
types
A
- femoral neck
- intertrochanteric
- subtrochanteric
- look at picture
5
Q
Femoral neck fractures
subtypes
A
- nondisplaced: incomplete or impacted fx; complete w/o displacement
- Displaced: complete with parital displacement; complete with full displacement
- displaced disrupts the cortex of the bone
6
Q
Femoral head blood supply
A
- femoral artery: profunda femoris
- medial and lateral circumflex artery
- multiple ascending branches along femoral neck that may be disrupted with a fracture
7
Q
Treatment for non-displaced femoral neck fractures
A
- intra and extra-osseous blood supplies should be intact
- usues in-situ pinning
- cannulated screws
- inverted triangle orientation
8
Q
Treatment for displaced femoral neck fractures
A
- blood supply is disrupted
- osteoporosis may be a condition
- chronic medial problems
- hemiarthroplasty
9
Q
advantages of hemiarthroplasty
for a femoral neck fracture
A
- immedate WBAT
- elderly maybe unable to comply with WB restrictions
- fracture is eliminated
- minimizes down time
- may wear down the articular cartilage of the socket
10
Q
femoral neck fractures: complications
A
- osteonecrosis
- non-union
11
Q
Femoral neck fractures
complications: osteonecrosis
A
- blood supply is interrupted
- necrosis/femoral head collapse
- typically more in displaced
- tx: re-operation with prosthetic replacement
can cause pain 6months - 1 year
12
Q
Femoral neck fracutres
Complications: non-union
A
- fracture does not heal
- displaced fx (10-30%)
- re-operation necessary: typically prosthetic replacement but sometimes ORIF
13
Q
Intertrochanteric hip fractures
subtypes
A
- stable: nondisplaced w/o comminution or displaced with minimal comminution
- unstable: displaced extensive posteromedial comminution or 3 subtrochanteric extension
14
Q
Intertrochanteric hip fractures
treatment
A
- stale and unstable fx
- cephalomedullary IM nails (biomechanically better)
- compression screws can also be used
15
Q
Intertrochanteric hip fractures
trochanteric fixation nail
A
- IM approach to proximal femur
- indications for short nail:
- *stable and unstable fx
- peritochanteric
- intertrochanteric
- basilar neck fx
- cominations of above*
- Alternative to: sliding hip screws-side plate device
